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DescriptionIn Boston, local government officials used a traveling health van to make chronic disease screening services available to public housing residents at housing developments. But low use of these services suggested new motivational and recruitment strategies were needed to increase screening rates. The Boston PRC explored whether resident health advocates (RHAs) and peer leaders could encourage residents to visit the vans for screening for hypertension, diabetes, and dental disease, and increase the number of participants who kept follow-up appointments made after initial screening.

Two intervention and control sites were chosen, based on availability of nearby medical clinics for follow-up appointments and enough space for a screening van to maneuver, park, and operate onsite. RHAs at intervention sites helped identify peer leaders in the community to raise awareness of and interest in screening before van visit days. At the time of screening, RHAs helped residents schedule follow-up appointments, asked about insurance coverage, and arranged transportation to clinics. At comparison sites, flyers were circulated about the van visit dates, and use of the vans was noted.

The researchers found a statistically significant difference in screening rates between intervention and control groups of residents. For 2007 and 2008 combined, 6.8% of residents were screened at sites that had RHAs, compared with 4.3% at sites that did not. At the developments using RHAs, follow-up visit attendance improved from 15% in 2007 to 55% in 2008. These findings suggest RHAs help motivate fellow residents to obtain screening for selected health conditions and to have follow-up appointments when needed.